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Objectives: Previous studies have found a negative population-level correlation between medical marijuana availability in US states, and trends in medical and nonmedical prescription drug use. These studies have been interpreted as evidence that use of medical marijuana reduces medical and nonmedical prescription drug use. This study evaluates whether medical marijuana use is a risk or protective factor for medical and nonmedical prescription drug use.

Methods: Simulations based upon logistic regression analyses of data from the 2015 National Survey on Drug Use and Health were used to compute associations between medical marijuana use, and medical and nonmedical prescription drug use. Adjusted risk ratios (RRs) were computed with controls added for age, sex, race, health status, family income, and living in a state with legalized medical marijuana.

Conclusions: Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.

School of Public Health, College of Medicine and Health, University College Cork, Republic of Ireland (TLC); Drug Policy Institute, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL (TLC); Veterans Affairs Center for Innovation to Implementation, Stanford University, Stanford, CA (KH).

Conflicts of interest: TLC was supported by the George J. Mitchell Scholarship of the US-Ireland Alliance. KH was supported by a Senior Career Research Scientist Award from the Veterans Affairs Health Services Research and Development Service and by a grant from Stanford Neurosciences Institute.

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